Abstract：Objective：To explore the incidence pattern，risk factors，targeted prevention and management strategies of severe complications after laparoscopic cholecystectomy（LC），so as to provide a reference for standardized clinical operation and reducing the incidence of complications.Methods：The clinical data of 3000 patients who underwent LC in our hospital from January 2018 to December 2023 were retrospectively analyzed. The incidence and type distribution of severe complications（including bile leakage，extrahepatic bile duct injury，massive intra-abdominal hemorrhage，gastrointestinal injury，septic shock，etc.）were statistically analyzed. The correlation between the occurrence of complications and factors such as patient disease characteristics，surgical timing，and severity of gallbladder lesions was explored，and the preventive measures and management experience were summarized.Results：Among the 3000 patients，42 cases developed severe complications，with an overall incidence of 1.40%. Specifically，there were 22 cases of bile leakage（0.73%），9 cases of extrahepatic bile duct injury（0.30%），7 cases of massive intra-abdominal hemorrhage（0.23%），3 cases of septic shock（0.10%），and 1 case of other complications（0.03%）. Univariate analysis showed that acute suppurative cholecystitis，gallbladder atrophy，impacted gallbladder neck stones，previous abdominal surgery history，and inappropriate surgical timing were risk factors for severe complications（P<0.05）. All patients with complications were cured and discharged after targeted treatment，with no death cases.Conclusion：The occurrence of severe complications in LC is related to multiple risk factors，such as the severity of the disease，variations of bile ducts and blood vessels，and the clarity of Calot’s triangle. The incidence of complications can be effectively reduced by precise preoperative evaluation of high-risk factors，standardized and meticulous anatomical operation during surgery，and close postoperative monitoring. Once relevant complications occur，timely individualized treatment measures can be taken to improve the prognosis of patients.
Li et al. (Thu,) studied this question.